Nurse to Patient Ratio Mandates

Nurses Activism

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I'd like to hear more about nurse-patient ratios. What is considered safe for each denomination and nursing specialty? (ER, OR, MED/Surg, L&D, ect.,). How many patients can be assigned to a floor (bedside) RN simultaneously and still be considered safe? To my knowledge, only 1 state in the United States is legally bond to limit nurse-patient ratios. That state is California. BUT what I have seen there is the hospitals, facilities, methods of circumventing this: namely, "ON-CALL.". Many RNs are placed ON-CALL very severely (500 hours per month) to circumvent them being 'assigned' a massive patient case loads but must remain available for ANY amount, meaning they can work 12 hour shifts then afterward are given ON CALL status where they can be given many more patients to care for, or very rarely, just a few. Plus, I want to know what is LEGALLY REQUIRED for the employer to divulge to a prospective employee. Example: A nurse is hired to work 3 12-hour shifts per week to be deemed full-time, AND is told she/he will be assigned a patient load of a maximum 6 patients. BUT, when he/she is working that job, he/she is assigned MORE than 6 patients (7---25 patients), plus the ON-CALL status of "one week-end per month" is EVERY week-end per month, because the hospital sites "nursing shortage". IF a nurse (RN) cannot or refuses unknown about or unplanned for ON-CALL assignments--he/she will be fired. Meaning NO unemployment benefits, NO reference, and YES to "no rehire" status which prospective HR employer reps. automatically view as "undesirable". What are the LEGAL perimeters of Hospitals towards RN employment?

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Specializes in Critical care, tele, Medical-Surgical.

Here is a link to the California ratio regulations:

https://govt.westlaw.com/calregs/Document/I8612C410941F11E29091E6B951DDF6CE?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=%28sc.Default%29

California requirements for registered nurses. These regulations make it clear that each patient must be assigned to a registered nurse:

https://govt.westlaw.com/calregs/Document/IFD69DB90621311E2998CBB33624929B8?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=%28sc.Default%29

No hospital I know of schedules nurses for more than 12 hours in a 24 hour period. Our overtime laws require thatany work in excess of 12 hours in one day must be compensated at the rate of no less than twice the regular rate of pay for an employee.

CA Codes (lab:500-558)

Lots more on ratios:

National Campaign for Safe RN-to-Patient Staffing Ratios | National Nurses United

In what country or state are registered nurses placedon call 500 hours per month?

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Specializes in Critical care, tele, Medical-Surgical.

Error. Double post.

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Specializes in NICU, PICU, Transport, L&D, Hospice.

500 hours of oncall/month for a nurse who is already working full time? really?

how does that work exactly given that there are only roughly 730 hours total/month and the RN presumably is working approximately 170 of the hours at his/her full time job leaving only 560 hours in the month for days off, sleeping, etc.

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Has any one called the Labor Board?

Lindarn, RN, BSN, CCRN, (ret)

Somewhere in the PACNW

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